Optical fiber instrument system for dynamic recalibration

ABSTRACT

An instrument system that includes an elongate body, an optical fiber and a controller is provided. The optical fiber is at least partially separate from the elongate body. The controller is operatively coupled to the elongate body and to the optical fiber and the controller is adapted to receive a signal from the optical fiber, detect movement of the optical fiber based on the signal; and update a position of the elongate body relative to the optical fiber based on the detected movement.

RELATED APPLICATION DATA

The present application is a divisional of U.S. patent application Ser. No. 12/507,706, filed on Jul. 22, 2009, which claims the benefit under 35 U.S.C. §119 to U.S. Provisional Patent Application Ser. No. 61/137,628, filed on Aug. 1, 2008. The foregoing application is hereby incorporated by reference into the present application in its entirety.

FIELD OF INVENTION

The invention relates generally to remotely controlled medical devices and systems, such as telerobotic surgical systems or manually steerable catheters, and the employment thereof for conducting procedures in the heart, blood vessels, and other body lumens. More particularly, this invention relates to systems, apparatuses, and methods detecting the position of one or more instruments within one or more targeted tissue cavities during a minimally invasive diagnostic or therapeutic procedure.

BACKGROUND

It is generally desirable in minimally invasive medical procedures involving instruments such as catheters, probes, and the like to understand the spatial positioning of such instruments relative to nearby tissue structures, such as the walls of a cavity of a heart. In the cardiovascular market, for example, several systems are available for tracking position, or “localizing”, instruments—including but not limited to the system sold under the tradename “EnSite®” by St. Jude Medical, Inc., and the system sold under the tradename “CartoXP®” by the Biosense Webster division of Johnson & Johnson, Inc. The EnSite system utilizes potential differences between reference patches and instruments to localize instruments while the CartoXP system utilizes magnetic fields and currents detected by small coils coupled to an instrument to localize such instrument. Fiber bragg (hereinafter “FBG”) sensor technology and configurations have been disclosed, for example in U.S. Patent Applications 60/785,001, 60/788,176, 60/899,048, 60/900,584, 11/690,116, 60/925,449, 60/925,472, 60/964,773, 61/003,008, Ser Nos. 12/012,795, 12/106,254, the entirety of which are incorporated herein by reference, which allow for localization and shape sensing of elongate instruments. Depending upon the particular FBG configuration, such technology may enable not only localization of particular points along an elongate instruments, as with the aforementioned localization technologies, but also localization of the spatial position of an entire section of the length of such instrument—or the entire length of the instrument, for that matter. It would be advantageous to combine certain aspects of FBG localization and shape sensing technologies with more conventional localization technologies, such as those available from Biosense or St. Jude Medical, to provide a hybrid localization system capable of addressing certain shortcomings of the systems as individually deployed. Several such configurations are described here.

BRIEF DESCRIPTION OF THE DRAWINGS

The present disclosure will be readily understood by the following detailed description, taken in conjunction with accompanying drawings, illustrating by way of examples the principles of the present disclosure. The drawings illustrate the design and utility of preferred embodiments of the present disclosure, in which like elements are referred to by like reference symbols or numerals. The objects and elements in the drawings are not necessarily drawn to scale, proportion or precise positional relationship; instead emphasis is focused on illustrating the principles of the present disclosure.

FIG. 1 illustrates a system level view of a referenced localized configuration in accordance with one embodiment of the present invention.

FIG. 2 illustrates a diagrammatic view of a referenced localized configuration in accordance with one embodiment of the present invention.

SUMMARY OF THE INVENTION

In accordance with one aspect of the present disclosure, an instrument system that includes an elongate body, an optical fiber and a controller is provided. The optical fiber is at least partially separate from the elongate body. The controller is operatively coupled to the elongate body and to the optical fiber and the controller is adapted to receive a signal from the optical fiber, detect movement of the optical fiber based on the signal; and update a position of the elongate body relative to the optical fiber based on the detected movement.

In accordance with another aspect of the present disclosure, a method for tracking an elongate body is provided. The method includes receiving a signal from an optical fiber that is at least partially separate from an elongate body, detecting movement of the optical fiber based on the signal, and updating a position of the elongate body relative to the optical fiber based on the detected movement.

In accordance with yet another aspect of the present disclosure, a method for maintaining calibration of a medical device localization system is provided. The method include a. establishing a baseline calibration between the positions of one or more localization sensors coupled to an elongate medical instrument and one or more localization sensors coupled to a nearby reference medical instrument at known longitudinal positions along the instrument; and b. detecting repositioning of the reference medical instrument utilizing an optical fiber shape sensing system coupled to the reference medical instrument.

These and other aspects of the present disclosure, as well as the methods of operation and functions of the related elements of structure and the combination of parts and economies of manufacture, will become more apparent upon consideration of the following description and the appended claims with reference to the accompanying drawings, all of which form a part of this specification, wherein like reference numerals designate corresponding parts in the various figures. In one embodiment, the structural components illustrated can be considered are drawn to scale. It is to be expressly understood, however, that the drawings are for the purpose of illustration and description only and are not intended as a definition of the limits of the present disclosure. It shall also be appreciated that the features of one embodiment disclosed herein can be used in other embodiments disclosed herein. As used in the specification and in the claims, the singular form of “a”, “an”, and “the” include plural referents unless the context clearly dictates otherwise.

DETAILED DESCRIPTION OF THE ILLUSTRATED EMBODIMENTS

Referring to FIG. 1, an exemplary tissue structure complex comprising the right atrium, left atrium, inferior vena cava, superior vena cava (12), tricuspid valve (10), mitral valve (8), and coronary sinus is depicted for illustration purposes. Such tissue structures may be navigated and/or investigated utilizing a robotic catheter system comprising, for example, an outer steerable sheath catheter (30) and a coaxially-associated inner sheath catheter (18), such as those described with similar element labels in patent application Ser. Nos. 10/923,660, 10/949,032, 11/073,363, 11/173,812, 11/176,954, 11/179,007, 11/176,598, 11/176,957, 11/185,432, 11/202,925, 11/331,576, 11/418,398, 11/481,433, 11/637,951, 11/640,099, 11/678,001, 11/678,016, 60/919,015, 11/690,116, 60/920,328, 60/925,449, 60/925,472, 60/926,060, 60/927,682, 11/804,585, 60/931,827, 60/934,639, 60/934,688, 60/961,189, 11/762,778, 11/762,779, 60/961,191, 11/829,076, 11/833,969, 60/962,704, 60/964,773, 60/964,195, 11/852,252, 11/906,746, 61/003,008, 11/972,581, 12/022,987, 12/024,883, 12/024,760, 12/024,641, 12/032,626, 12/032,634, 12/032,622, 12/032,639, and 12/012,795, each of which is incorporated by reference in its entirety into this disclosure. A working instrument (2), depicted through the working lumen of the guide instrument (18), may be configured to map the electrical activity of the inside of the heart, ablate related tissues, inject, grasp, etc, as described in the aforementioned incorporated applications. Other remotely steerable systems, including those that are manually steered with handles and the like rather than electromechanical instrument driving mechanisms, may also be utilized for the subject procedures, systems, and apparatuses.

The coronary sinus (hereinafter “CS”) has a relatively unique anatomical geometry which substantially retains its form throughout the heart cycle. In other words, as one examines the shape of the CS, there are certain turns along its length that are substantially, but not entirely, retained as turns throughout the heart cycle. This presents a shape sensing opportunity. To maintain accurate localization of a working instrument configuration such as that depicted in FIG. 1, a reference instrument (4) comprising a FBG shape-sensing fiber having multiple sensors along its length may be placed in the CS, and the pattern of bending strain (detected via FBG shape sensing) along the length of such reference instrument (4) may be utilized to assist in the understanding of position detection of the associated working instrument configuration.

An illustrative embodiment is useful in describing further details regarding the foregoing improvement. Referring to FIG. 1, a conventional localization system is utilized to monitor the position of one or more sensors (6) coupled to the working instrument assembly (30, 18, 2)—in the depicted embodiment a single sensor (6) is coupled to the distal portion of the guide instrument (18); in other embodiments, more sensors may be coupled to the instrument assembly at other positions along the various instruments comprising the assembly. Each localization sensor preferably is operably coupled to a localization system (not shown) via an electronic coupling such as a thin conductive member or wire, which may comprise the body of one of the members (4). The localization sensors may be directly coupled to a surface of an associated instrument, or they may be physically integrated into the body of such instrument. Suitable localization systems, such as those available from the Biosense Webster division of Johnson and Johnson, Inc. under the tradename CartoXP®, Boston Scientific Corporation under the tradename RPM®, or St. Jude Medical, Inc. under the tradename EnSite®, are configured to output position and/or orientation information regarding each sensor, and may be operably coupled to an electromechanical instrument operation computing and/or controller system, such as those described in the aforementioned incorporated by reference applications, which may be operatively coupled to an electromechanical instrument driver configured to operate the instruments, also as described in the aforementioned incorporated by reference applications. Conventionally, a reference instrument may be placed in the vicinity of the working instrument assembly (30, 18, 2) having a series of localization sensors spaced apart longitudinally along the reference instrument at known lengths. The combination of these known spacing separations, and the data (potential difference or current data, for example) gathered from each reference instrument sensor, and the data (potential difference or current data, for example) gathered from the working instrument assembly sensor (6) may be utilized to determine the position of the working instrument assembly sensor (6) in space, in near-real-time. With such a configuration, if the reference instrument suddenly moves relative to the working instrument and/or anatomy, the system's understanding of the relationships between the various instruments generally is thrown off and the system needs to be recalibrated before precision localization of the working instrument assembly can continue. One solution to this challenge is to place the reference instrument into a relatively confined position, such as threaded into the CS. However, in the event that the reference instrument moves during a procedure (for example, as a result of heart movement, breathing, loads applied to associated structures, etc) relative to the confining structures (such as the CS), the system's understanding of the relationships between the reference instrument sensors and the working instrument assembly sensors are again thrown off. This problem may be remedied by associating fiber bragg sensing technology with the reference instrument—so that changes in the position of the reference instrument may be characterized in near-real-time, and so that the coordination of the reference catheter sensors and the working catheter assembly sensors may be continued. Referring again to FIG. 1, such an embodiment is depicted.

As shown in FIG. 1, a working instrument assembly (30, 18, 2) is positioned through the inferior vena cava (14), across the right atrium (24) of the heart (40). The guide (18) and working (2) instruments are placed across the atrial septum (22) into the left atrium (26), where it may be desirable to accomplish an interventional or diagnostic procedure. In the depicted embodiment, a single localization sensor (6) is coupled to the working instrument assembly at a location upon the distal end of the guide instrument (18); in other variations, one or more sensors may be placed at various locations along the assembly and instruments comprising the assembly. Also shown in FIG. 1, a reference instrument (4) is depicted positioned through the inferior vena cava, through the os (16) of the coronary sinus (20), and around the curved pathway defined by the coronary sinus (20). The reference instrument has three reference localization sensors (labeled A, B, and C in FIG. 1) spaced apart longitudinally at known distances, and preferably comprises a flexible probe, guidewire, or catheter coupled to a fiber bragg sensing fiber (28) in a manner such as those disclosed in the aforementioned incorporated FBG-related applications. In another embodiment, one or more localization sensors may be present, as opposed to three or more. The FBG fiber may comprise a series of discrete bragg gratings, or may be configured with a set of continuous or substantially continuous gratings, to provide high-resolution bending sensing along the length of the fiber positioned through the coronary sinus; the fiber may be a simple single core fiber, which is capable of sensing bending along the length of the fiber, or may comprise a multi-core fiber configuration with additional shape sensing capabilities, as described in the aforementioned incorporated FBG-related applications. Further, the fibers may be loosely coupled to the shape of the associated instrument, or may be physically integrated to the body of the associated instrument. With the FBG fiber (28) coupled to the reference instrument (4), and both positioned through the CS (20), turns in the anatomical geometry of the CS (20) are seen as increases in strain amplitude at the FBG analyzing system (not shown—available from suppliers such as Luna Innovations, Inc., Micron Optics, Inc., etc—described in the aforementioned FBG-related incorporated applications). Given both conventional localizing sensors and the bragg grating sensors along the length of the reference instrument (4), one is able to map bending strain (via the FBG system) versus localized position (via the conventional localization system) and have an effective “fingerprint” of the reference instrument relative to the coronary sinus (20) anatomy. Should the reference instrument (4) suddenly move relative to the coronary sinus (20) anatomy, the system preferably is configured to not only 1) detect such movement by seeing a shift in the positioning of the bends in the FBG fiber relative to the reference localization sensor positions; but also 2) automatically recalibrate the system for the movement due to the data acquired from the FBG fiber and reference localization sensors (i.e., the system understands that the reference instrument has shifted relative to the CS, and can calculate by how much based upon the bending location movement longitudinally along the FBG fiber and the localization data from the reference localization sensors (labeled A, B, and C in FIG. 1). A transformation matrix or similar controls tracking structure may be utilized to maintain the up-to-date relationship between the reference instrument and the working instrument.

In one embodiment, the system may be configured to stop (navigation or instruments, feedback of localization data, or both) or signal the operator upon determining that the reference catheter has moved relative to the CS. In one embodiment, the system may be configured to constantly buffer a relevant amount of reference instrument sensor position data, and detect a delta larger than a certain predetermined threshold amount to make a determination that the reference catheter has “moved” relative to the CS; such a threshold may be intraoperatively programmable to accommodate different localization system accuracies. As described above, once a move has been detected, the system may be configured to characterize the move, account for it in a transformation matrix, and continue with the operation with the relationships of the reference instrument and working instruments continually understood.

In another variation, in the event that it is determined that something in the localization system has moved, and it can be determined using the above techniques that the reference catheter has not moved relative to the anatomy, then it may be determined that another component of the reference system has moved, such as a potential difference contact patch in the EnSite localization system—and this problem may be addressed without a complete restart of such system.

Several techniques may be utilized for mapping the strain and localization of the reference sensor within the coronary sinus. In one embodiment the FBG-reference instrument complex may be inserted into the CS, then pulled out again to produce redundant data regarding strain (from bending) and localization mapping; such insertion and/or retraction may be automated by utilizing, in a robotic variation as depicted in FIG. 1 (suitable robotic catheter systems being described in the aforementioned incorporated applications), robotic navigation features such as “autoretract” or simple electromechanically actuated and/or controlled insertion and/or retraction. In another variation, such insertion/retraction may be repeated to produce a more refined knowledge of the strain/localization patterns associated with the CS anatomy longitudinally through the heart.

In one embodiment (not shown), the reference instrument may be delivered to the diagnostic or interventional theater using one or more components of the working instrument assembly, rather than independent delivery as shown in FIG. 1; for example, a reference instrument such as that depicted in FIG. 1 may be carried to the right atrium (24) by the sheath instrument (30), where it may exit the sheath instrument (30) through an aperture or the like and enter the right atrium and coronary sinus (20) as an independent instrument branching away from the sheath instrument (30). If carried to the theater by a relatively large and relatively stiff structure such as the depicted sheath instrument (30), the proximal portion of the reference instrument (4) positioned within the sheath (30) is likely to have relatively little active bending activity until the reference instrument (4) exits the sheath (30) and the distal tip branches away from the sheath (30). This branching away point (142) is likely to be seen through FBG fiber bending monitoring as an increase in strain amplitude activity—and thus a reference point may be tracked for such point to provide additional data to the localization systems, such as the ability to reject common mode errors in the monitoring of positions of the instruments (such as heart movement or breathing artifact). Indeed, in another embodiment not having any conventional localization sensors, a Y-shaped configuration having one FBG fiber along a working instrument assembly and another fiber branching away from such assembly and into another cavity such as the CS would enable common mode rejection benefits, and in an embodiment wherein such FBG fibers are multicore FBG fibers, such as tricore FBG fibers, the branching-off point could be utilized to monitor shape and location of the two instrument assemblies without additional localization sensors.

In another embodiment, a hybrid configuration may be utilized wherein a simple localization sensor, such as that (6) depicted in FIG. 1, may be placed upon a diagnostic or therapeutic instrument, and a FBG fiber (not shown—may be single or multiple fiber configuration) may be coupled to the body of the same instrument assembly proximal and/or distal of this localization sensor (6). Depending upon the localization system utilized, this would provide 5 or 6 degree of freedom localization of the sensor (6) location, and shape sensing of the body of the same instrument assembly. Further, impendance or complex impedance monitoring or other contact sensing techniques may be added to the instrument assembly functionality to provide contact mapping capability for mapping nearby tissue structures and cavities defined by them.

Referring to FIG. 2, a diagrammatic illustration of one embodiment of the subject calibration technology is depicted. A localized working instrument, such as a cardiac catheter, is placed in a targeted position relative to pertinent anatomy (42). A reference instrument which is both localized with localization sensors, and coupled to a Bragg shape sensing fiber, is placed in a reference anatomical position, generally selected such that the reference instrument will not accidentally become repositioned (44). A baseline “fingerprint” accounting for the relationship between the localization sensor data from the reference instrument and the localization sensor data from the working instrument, and also for the relationship between the localization sensor data (from the reference instrument localization sensors positioned at known longitudinal positions along the reference instrument) and the shape sensing data pertinent to the reference instrument (46). With everything calibrated, the working instrument may be operated and localized with reference to the reference localization sensors on the reference instrument (48). If there is repositioning of the reference instrument, this may be detected utilizing the shape and localization data pertinent to the reference instrument (50), and the system, comprising, for example, a system controller operatively coupled to both a localization controller (such as the aforementioned EnSite® device) and a shape sensing controller (such as the aforementioned systems available from Luna Innovations, Inc.) may use the data from both coupled controllers to automatically recalibrate, thereby taking into account the relative reposition, such as by determining a new or updated transformation matrix to apply when interpreting the data from both controllers (52).

These techniques may be utilized in other organs and cavities—the aforementioned examples wherein the coronary sinus is used as an auxiliary cavity adjacent the right or left atrium are for illustration purposes; the techniques may be broadly applied to assist in the accurate localization of instruments in cavities throughout the body, large and small, wherein an adjacent structure having a substantially predictable geometry which may be bending-mapped and monitored with a reference instrument is available.

While multiple embodiments and variations of the many aspects of the present disclosure have been disclosed and described herein, such disclosure is provided for purposes of illustration only. Many combinations and permutations of the disclosed system are useful in minimally invasive medical intervention and diagnosis, and the system is configured to be flexible. The foregoing illustrated and described embodiments of the present disclosure are susceptible to various modifications and alternative forms, and it should be understood that the present disclosure generally, as well as the specific embodiments described herein, are not limited to the particular forms or methods disclosed, but also cover all modifications, equivalents and alternatives. Further, the various features and aspects of the illustrated embodiments may be incorporated into other embodiments, even if no so described herein, as will be apparent to those skilled in the art. 

1. An instrument system, comprising: an elongate body; an optical fiber at least partially separate from the elongate body; a controller operatively coupled to the elongate body and to the optical fiber and adapted to: receive a signal from the optical fiber; detect movement of the optical fiber based on the signal; and update a position of the elongate body relative to the optical fiber based on the detected movement.
 2. The instrument system of claim 1, wherein the optical fiber has a strain sensor and a localization sensor provided thereon, and wherein the controller is adapted to receive the signal from the strain sensor, to receive another signal from the localization sensor, and to update the position of the elongate body based on the another signal.
 3. The instrument system of claim 2, wherein the localization sensor comprises a potential difference sensor or an electromagnetic sensor, wherein the strain sensor comprises a bragg grating, and wherein the controller is adapted to update the position of the elongate body relative to the optical fiber further based on the signal from the strain sensor.
 4. The instrument system of claim 1, wherein the elongate body and the optical fiber are adapted to be located inside a patient.
 5. The instrument system of claim 4, wherein a portion of the optical fiber is coupled to the elongate body and another portion of the optical fiber branches away from the elongate body, wherein the another portion of the optical fiber is adapted to be located in a structure inside the patient and the elongate body is adapted to be located outside the structure.
 6. The instrument system of claim 5, wherein the structure comprises a coronary sinus cavity.
 7. The instrument system of claim 1, wherein the controller is adapted to update the position of the elongate body relative to the optical fiber by updating a spatial relationship between the elongate body and the optical fiber.
 8. The instrument system of claim 7, wherein the controller is adapted to update the spatial relationship by updating a transformation matrix.
 9. The instrument system of claim 7, wherein the controller is adapted to determine movement of the optical fiber further by buffering a position of the optical fiber over time and by determining whether a change in the buffered position exceeds a predetermined threshold.
 10. The instrument system of claim 1, wherein the elongate body comprises a catheter having a tool provided on a distal tip of the catheter, and wherein the controller is adapted to update the position of the elongate body by updating a position of the distal tip.
 11. A method for tracking an elongate body, comprising: receiving a signal from an optical fiber that is at least partially separate from an elongate body; detecting movement of the optical fiber based on the signal; and updating a position of the elongate body relative to the optical fiber based on the detected movement.
 12. The method of claim 11, wherein the optical fiber has a strain sensor and a localization sensor provided thereon, wherein receiving the signal comprises receiving a signal from the strain sensor, the method further comprising receiving another signal from the localization sensor, wherein updating the position of the elongate body is based on the another signal.
 13. The method of claim 12, wherein the localization sensor comprises a potential difference sensor or an electromagnetic sensor, wherein the strain sensor comprises a bragg grating, and wherein the updating the position of the elongate body is further based on the signal from the strain sensor.
 14. The method of claim 11, wherein the elongate body and the optical fiber are adapted to be located inside a patient.
 15. The method of claim 14, wherein a portion of the optical fiber is coupled to the elongate body and another portion of the optical fiber branches away from the elongate body, wherein the another portion of the optical fiber is adapted to be located in a structure inside the patient and the elongate body is adapted to be located outside the structure.
 16. The method of claim 15, wherein the structure comprises a coronary sinus cavity.
 17. The method of claim 11, wherein the updating the position of the elongate body relative to the optical fiber comprises updating a spatial relationship between the elongate body and the optical fiber.
 18. The method of claim 17, wherein the updating the spatial relationship comprises updating a transformation matrix.
 19. The method of claim 17, wherein the detecting movement of the optical fiber further comprises buffering a position of the optical fiber over time and by determining whether a change in the buffered position exceeds a predetermined threshold.
 20. The method of claim 11, wherein the elongate body comprises a catheter having a tool provided on a distal tip of the catheter, and wherein the updating the position of the elongate body comprises updating a position of the distal tip.
 21. A method for maintaining calibration of a medical device localization system, comprising: a. establishing a baseline calibration between the positions of one or more localization sensors coupled to an elongate medical instrument and one or more localization sensors coupled to a nearby reference medical instrument at known longitudinal positions along the instrument; and b. detecting repositioning of the reference medical instrument utilizing an optical fiber shape sensing system coupled to the reference medical instrument.
 22. The method of claim 21, further comprising notifying an operator of the elongate medical instrument that a recalibration is required.
 23. The method of claim 21, further comprising stopping any automated motion associated with the elongate medical instrument.
 24. The method of claim 21, wherein detecting repositioning comprises saving in a buffer a predetermined amount of data pertinent to the positioning of the reference medical instrument and comparing such buffer data to newly determined positioning data.
 25. The method of claim 21, further comprising automatically recalibrating the positions of the one or more localization sensors coupled to an elongate medical instrument and the one or more localization sensors coupled to a nearby reference medical instrument based upon changes in position or shape of the reference medical instrument detected by the localization and shape sensing systems.
 26. The method of claim 21, further comprising positioning the elongate medical instrument adjacent targeted tissue structures, and positioning the reference medical instrument nearby in a substantially more constrained position relative to nearby anatomy, to prevent substantial motion of the reference medical instrument.
 27. The method of claim 26, wherein the elongate medical instrument is placed within one of the chambers of the heart.
 28. The method of claim 27, wherein the reference medical instrument is placed within the coronary sinus of the heart.
 29. The method of claim 26, further comprising retracting and repeating positioning the reference medical instrument nearby in the substantially more constrained position relative to nearby anatomy, to gather additional data regarding the shape of the anatomy. 